Normal pregnancy in a woman with nesidioblastosis treated with somatostatin analog octreotide

Abstract

Our study demonstrates that: 1) octreotide treatment can be effective in controlling endogenous hyperinsulinism during pregnancy; 2) octreotide does not affect physiological changes during pregnancy such as insulin-resistance or placental GH level; 3) exposure of the foetus to octreotide throughout pregnancy does not induce any malformation and does not affect foetal development.

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

“…Although octreotide crosses placental barrier and placenta has somatostatin receptors that bind octreotide (78), no serious adverse fetal outcomes have been detected in nearly 50 (2,3,4,5,7,36,38,47,48,50,51,55,57,63,79,80,81,82,83,84) cases of transient exposure (mostly in first trimester) nor in a much smaller number of continuous exposure to somatostatin analogs (SA) and/or dopaminergic agonists (4,64,73,75,78,85,86,87). Notwithstanding, concerns about low birth weight associated to fetal exposure to SA either alone or, as more often reported, in combination with dopaminergic agonists (DA) have been raised by a large retrospective study and by few case reports (3,4,85,88).…”

Diagnosis and Treatment of Insulinomas in the Adults

“…Longterm treatment with somatostatin analogues has also been reported to be effective, without the side effects of diazoxide (Vezzosi et al 2008). One of our patients was treated with continuous subcutaneous administration of a high dose of octreotide throughout her pregnancy, without any detectable maternal or foetal adverse effect (Boulanger et al 2004). Calcium channel blockers have been employed (Witteles et al 2001) (Vella & Service 2007).…”

Anaesthetic management of a pregnant woman with carcinoid disease

“…However, there have been several reported cases where octreotide has been given for long periods during pregnancy, without any suggestion of abnormal postnatal development. [9][10][11][12] It is recommended in the Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumours of the gastroenteropancreatic system that a 500-1000-lg i.v. bolus be given 1-2 h before emergency surgery in patients with functional neuroendocrine tumours.…”